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Please find below the report (also attached), photo and video links of the Janki Foundation Annual Lecture held on 27 November 2017, 'Cultural Depression: A help or hindrance?’ – With Prof Dinesh Bhugra and Sister Jayanti chaired by Neville Hodgkinson. Song by Karishma Patel and poem by Dr Sarah Eagger.

We received great feedback from the programme and many people requested the video link. Apologies for the delay in sending this out, we had some technical issues!

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Janki Foundation

Janki Foundation for Spirituality in Healthcare

Celebrating 20 years of Service

Cultural Identity and Depression: A help or hindrance?

The Janki Foundation Annual Lecture, 27th November 2017, GCH, LONDON

REPORT

The Annual General Meeting (AGM) for The Janki Foundation was held earlier in the evening with around 60 people attending. The Foundation is celebrating its 20th anniversary this year and so the Chairman’s report included a presentation of the key milestones and achievements over the 20 years. Everyone who had contributed to the Foundation’s success over the years was thanked by name, and a set of Compassion Blessings was given to everyone attending.

Annual Lecture: With more than 160 present and over 100 joining online, Neville Hodgkinson opened the evening by informing everyone that Dr Sarah Eagger had now taken on the role of Chair for the Janki Foundation. Neville also gave thanks to the contributions of many to The Janki Foundation and the inspirations of Dadi Janki: The foundation continues to fund Global Hospital, and continues to educate many who work in the health care profession across the world, in understanding healthcare from a spiritual perspective as well as helping people understand a deeper perspective of illness.

Neville introduced the annual lecture special guest and speaker for the evening: ProfessorDinesh Bhugra, CBE. He has recently stepped down as president of World Psychiatric Association after a three-year term and has been elected as next president of the British Medical Association. ‘He is very charming and humorous and we are going to enjoy his presentation tonight’: Neville concluded with the question: Are there cultural influences in the way we understand depression?

Professor Bhugra gave a fascinating lecture using a presentation to pace through many aspects and symptoms of various levels of depressive illness as well as highlighting studies pointing to cultural factors affecting vulnerability. He emphasised the importance of seeing the patient holistically and asked, what are the circumstances that trigger depressive episodes and cause ill health to develop?

‘One major challenge with depression is there are many languages with no word for depression. This word only emerged when we saw the body as a machine. Up until then it was called melancholia. I am going to illustrate how symptoms of depression appear, how people respond and how people seek help.’

He also defined the term ‘culture’: as a common heritage or set of beliefs, norms and values. This in turn creates a system of shared meanings and cultural dynamic and identity. Yet he remarked that ‘cultures change and we change with culture and cultures change with us…it is a dynamic dialogue between the individual and collective.’

He also noted that depression has become prevalent across many cultures at this time, and yet people deal with it in many different ways. He explained how one common cause is when people experience ‘a sense of entrapment and defeat, and we suppress our natural explorative nature. It is the ‘arrested flight’ experience.’

He said there is a need now to educate patients to understand what is happening. And that these days mental health is too important to be left just to the ‘experts’. That we all need to get involved, understand and support. He passionately expressed how essential it is to give people more information so they can recognize depression and understand where to seek help, in their cultural context.

He also noted that depression is a universal experience, yet the language about it can differ and the meanings and symptoms can be very different according to individuals, culture and religious inclination. So management strategies need to be appropriate. There is also a wide spectrum of physical symptoms. Cognitive Behavioral Therapy (CBT) is used widely but we should not expect one size to fit all.

Neville thanked Professor Bhugra for his ‘wonderful review of the subject’. ‘I can understand why he has been given such high office’ Neville said. ‘He is very practical in seeing how to improve the care of patients through his research, and in helping both doctors and patients to understand the condition better, and to see what patients can do for themselves.’

Before entering into conversation with Professor Bhugra, Sister Jayanti noted how the development of the nuclear family and the breakdown of neighbourhoods has led many to feel isolated, creating situations that lead to depression. Culture, in this aspect, can make a major difference. Conditions in the world are also highly stressful for many, with much negativity, especially in societies that are very competitive. Both stress and depression are relatively new ailments of the human spirit, she said; there was not a term for either before the 20th century: the term ‘stress’ used to be applied to metal, not human beings.

While recognizing the need for psychiatry and other forms of professional support, she emphasised that spirituality can be a big factor in helping people with this condition. Understanding our own inner identity, coming to terms with that, and seeing what we are capable of, can lift people out of depression. She also noted that sometimes culture can be a hindrance…when through a strong cultural identity, there is a refusal to acknowledge mental illness.

Points arising from the conversation that followed:

· Part of the acculturation process is to learn to hide parts of ourselves so that we feel accepted.

· In today’s world ‘social capital’ is highly regarded: how we are perceived by peers and the social group we identify with. We can see this in the use of social media and the obsessions people have with their profiles.

· Spirituality can contribute to this social capital….where there is a sense of purpose, belonging and being, such that even when we are living with uncomfortable thoughts, we are able to carry on.

· Cultures across the world are in transition…and human nature has a great capacity for adjustment.

· Spirituality can play a major role in helping people get out of the sense of ‘entrapment’ and the anguish associated with it. For example, a sense of entrapment ‘as a woman’ in a male-dominated society can be overcome when we realise we impose barriers on ourselves by identifying with the gender we inhabit. With spirituality, we look at our inner identity.

· In terms of society and culture there is often a dichotomy between the egocentric self and the collective self. In the west, it is egocentric dominance, while historically in the east the collective has been more dominant.

Egocentric societies tend to have higher rates of crime and other forms of social breakdown.

· The notion of social capital is important. Belonging to a group that has common values can protect us from depression and anxiety. Social rituals such as gathering and eating together as families reduce egocentric drives, and promote wellbeing. Many of these rituals are in dramatic decline, as more people move away from traditional religious practices, and adopt faster work schedules.

· There is however a rise in interest in spiritual ideas, as people feel an increasing sense of ‘emptiness’, and a disillusionment with globalization and the increased disparity it has brought between rich and poor. There is a need to find a balance between science and spirituality.

· We need a sense of belonging, to enjoy wellbeing. We need something to ground us, to be part of a community. Where this is absent, severe loneliness and depression are likely to result.

· The highest sense of belonging is to feel connected to the entire human family. When we are in touch with our spiritual identity and belong to a community of higher values and ideals, we recognize that we are not just part of one race or religion.

· Neediness often shows up in a depressive illness and we have to recognize where a patient is coming from – for example, what are the immediate contexts of kinship and social capital.

· Part of the tragedy of medicine has been to over-focus on diseased organs, rather than on people.

· Both spirituality and psychiatry can help by bringing social functioning back into focus. Spirituality, through its emphasis on identifying with the inner being, enables us to learn how to discipline and channel the mind in very useful ways.

· Within certain religious cultures it has been thought that depression is the ‘wrath of God’, yet guilt and shame put a big barrier to transforming thoughts and feelings and recovering from mental illnesses.

· Society is changing rapidly and we still don’t quite understand the huge impact this is having on people’s lives and our ability to function within this context.

· People are feeling less and less valued and as a consequence have lost touch with their innate worth.

· Many feel left behind in today’s fast-moving technological world.

· There is also concern about an over-dependency on the drug industry. More work needs to be done on patient- focused interventions, as one size doesn’t fit all.

· It is time now to respect the contributions made by professionals to our wellbeing, and at the same time patients need to become professionals in helping themselves – and spirituality helps in this.

Sister Jayanti closed with a powerful meditation:

Reflecting on the evening, I watch what is going on in my mind….I realise that I have a choice….I can let my mind go into avenues of negativity ….things are difficult….so many challenges come our way every day and we meet difficult people every day…is that what I want to dwell on…..let me explore another path….to explore the original beauty of the self…..every soul has goodness…..every soul in its original pure state is filled with beauty, truth and love….and for a few minutes this is what I wish to explore….I allow myself to connect with that inner beauty in which I the soul truly reflect on the qualities of the Creator…I was created as the image of the Divine….peace….compassion…truth….belong to the soul….deep down within myself… I know that these exist and as I journey inwards, this is what I connect to. Becoming aware of who I truly am restores my value and confidence in myself….without ego…but with true dignity, keeping in my awareness my own original qualities….I come back to the awareness of here and now…and the things I need to do here, while connected with the inner being and the beauty and truth within.

Neville gave thanks for an evening full of insight and clarifications, with much wisdom shared by both speakers. Thanks were also given to Brahma Kumaris for hosting the event and the Janki Foundation team, who coordinated it.